Abstract
BackgroundCurrent experimental research suggests antihypertensive medication reduces the failure risk of dental implants due to enhanced bone remodeling. However, evidence from clinical studies evaluating the impact of antihypertensive medication on implant stability is lacking.MethodsWe retrospectively analyzed 377 implants in 196 patients (46 implants inserted in antihypertensive drug users (AH) and 331 implants in non-users (NAH)) for implant stability measured by radiofrequency analysis, and we determined the implant stability quotient (ISQ). AH subgroups were stratified by the use of beta-blockers, renin-angiotensin system (RAS) inhibitors, and both of the aforementioned. The impact of antihypertensive medication on ISQ values at implant insertion (primary stability) and implant exposure (secondary stability) was analyzed by a linear regression model with a regression coefficient and its 95% confidence interval (95% CI), adjusted for potential confounders.ResultsTime between implant insertion and implant exposure was 117.1 ± 56.6 days. ISQ values at insertion were 71.8 ± 8.7 for NAH and 74.1 ± 5.6 for AH, respectively. ISQ at exposure was 73.7 ± 8.1 for NAH and 75.7 ± 5.9 for AH. Regression analysis revealed that none of the AH subgroups were significantly related to ISQ at implant insertion. However, renin-angiotensin system inhibitors (RAS) were significantly associated with higher ISQ values at exposure (reg. coeff. 3.59, 95% CI 0.46–6.71 (p=0.025)).ConclusionsOutcome of the present study indicates enhanced bone remodeling and osseointegration following dental implant insertion in patients taking RAS inhibitors than in non-users. Future randomized prospective studies must confirm these indicative results.
Highlights
Current experimental research suggests antihypertensive medication reduces the failure risk of dental implants due to enhanced bone remodeling
As the success of osseointegrated implants highly depends on bone formation and remodeling processes, there might be a benefit for antihypertensive drug users who were treated with dental implants
Population and group characteristics Overall, 196 patients with a total of 377 implants were enrolled in this study (96 (49.0%) females and 100 (51.02%) males, with a median age of 65 years); 179 (47.5%) dental implants were placed in females whereas 198 (52.52%) were implanted in males
Summary
Current experimental research suggests antihypertensive medication reduces the failure risk of dental implants due to enhanced bone remodeling. The periodontal tissue renin-angiotensin system (tRAS) has been suggested to be involved in the progression of inflammation and bone loss mediated by angiotensin II (ATII), the main effector of the RAS [12, 13]. Recent preclinical studies provided evidence that RAS-inhibitors reduce periodontal inflammation and increase alveolar bone volume [12, 14,15,16]. Few studies investigated the impact of other antihypertensive drug groups on bone-relevant parameters suggesting higher bone mineral density and reduced bone fracture risk in patients treated with beta-blockers compared to calcium channel blockers, thiazides, or patients who never used antihypertensive medication [21,22,23,24]
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